As policymakers convene to review the progress of MIPAA implementation and discuss how to achieve the goals of the UN Decade, they are facing unprecedented urgency—and also a unique opportunity—to spur a global effort to promote healthy ageing. The rate of population ageing is accelerating, especially in low-and middle-income countries, while the covid-19 pandemic has kindled a renewed focus on older adults and health equity. Crucial to this effort is stakeholders from all sectors working collectively to create new solutions. 

Urgent need for action 

The pace of population ageing is accelerating. According to the UN’s latest World Population Prospects, the global older population will double by the middle of this century. By 2050 one in six people will be aged 65 or above. Low-and middle-income countries (LMICs) will account for 85% of the older population growth, and in 2050 four out of five people aged 65 or above will be residing in LMICs. As LMICs have less developed health and social protection systems compared with high-income countries, they face even greater challenges when adapting to an ageing population.

The covid-19 pandemic has further underscored the urgent need for new solutions. The crisis has laid bare fundamental shortcomings in the ability of global health systems to protect and provide care for older adults. While people aged 65 and older made up only 14% of confirmed cases, they accounted for close to 80% of all covid-19-related deaths. Economic fallout during the pandemic has also threatened the livelihood of workers in the informal economy, where 78% of those 65 and older globally are employed. The majority of these workers live in LIMCs and many have limited or no access to social protection or entitlement to employment benefits. Furthermore, the pandemic has amplified disparities among population segments, including older adults and caregivers, in areas ranging from income to health to digital access.

Imperative for innovative solutions and collective efforts

The imperative for promoting healthy ageing has never been so clear. To generate and implement innovative, inclusive solutions requires a life-course, whole-of-society approach that facilitates healthy, equitable ageing throughout individuals’ life spans.

Reimagine the existing paradigm and innovate

Many health systems—particularly in high-income and middle-income countries—were developed at a time when life expectancy was approximately 50-70 years. They no longer accommodate the needs of today’s older people, who regularly live more than 70 years with increased chronic conditions. Innovation requires reimagining models of care. It also encompasses practices to support ageing at home and in communities. Older adults should be enabled to participate in social and productive activities by mobilising stakeholders across sectors, leveraging existing platforms and technological tools and rethinking the role of older adults in society.

As illustrated in the Aging Readiness and Competitiveness (ARC) 3.0 report—which was released by AARP in October 2021, with data and analysis provided by Economist Impact—well-designed and-implemented practices can help people live longer and healthier while yielding broader social and economic outcomes. The report highlights the “hospital-at-home” model, which disrupts traditional models of care by bringing integrative acute-care practitioners and equipment directly into older adults’ homes. Another example is intergenerational self-help clubs that have been pioneered in Vietnam as a community-driven initiative to promote healthy ageing through activities ranging from home health visits and care to microfinance and technical assistance.

Adopt a life-course approach

Ageing is a lifelong process. Its trajectory is shaped by physical, social and economic environments and influenced by events such as the covid-19 pandemic and natural disasters. While health is essential to an individual’s experience of older age, health outcomes and socio-economic status—including education, employment and income—are inextricably intertwined through an individual’s life course, and disadvantages and disparities in these areas often reinforce each other. 

WHO highlighted “inclusiveness” and “equity” among the guiding principles for the UN Decade. These aspirations cannot be achieved without a life-course approach to ensure equal, just opportunities for all segments of society—irrespective of age, gender, ethnicity, ability, location or other social categories—to access healthcare, education, employment and financing, among other enablers of healthy ageing.

Singapore is a world leader in promoting lifelong learning, including its national initiative SkillsFuture, which encourages adults to direct their own learning and employers to provide on-the-job training and upskilling. Yet stakeholders in LMICs are also making increasing efforts to reduce disparities across the life course caused by gender, location and other social factors. In India, for example, the UN Capital Development Fund is partnering with the local government to develop the Mission Shakti Living Lab, an initiative to empower women through affordable financing, income-generating opportunities and skill development.

Fulfill the private sector’s potential as an agent of change

The life-course approach inevitably requires all parts of society—including governments, international organisations, civil society, the private sector and individuals—to work together in shaping the enabling factors for healthy ageing across individual lives. In particular, the private sector, which has historically been less active in promoting healthy ageing, can and should play an important role—not only as innovators and providers of products and services but also as employers for older individuals.

According to a survey by Economist Impact in 2021, 90% of executives and employees in the US agree that employers are an important player in health innovation and should be actively involved. The top three ways that employees selected for how employers can best contribute to their overall health and well-being were more company funding for health coverage costs, better work-life balance and increasing paid time off allocations. By taking these steps, employers can be essential agents of change to improve the health and well-being of their employees and the broader society.

While the pandemic has upended many lives and livelihoods, it has spurred a growing momentum for supporting healthy ageing. Only through continued commitment and meaningful, concerted actions will sustained, broad-reaching and inclusive progress be made.